Eficácia de intervenções farmacológicas na redução de massa corporal em adultos com sobrepeso e obesidade: uma revisão sistemática com meta-análise

According to the World Health Organization (WHO), in 2016, more than 1.9 billion adults, aged 18 and over, were overweight, 650 million of whom were obese. Thus, efficient treatment strategies are necessary to control these conditions, with drug therapy being indicated in some cases. In the literature, there is a lack of studies that compare the efficacy of different types of drugs in the treatment of obesity. Therefore, this systematic review with meta-analysis aimed to compare the efficacy of different pharmacological treatments on the reduction of body mass and the adverse effects on overweight and obesity, namely: orlistat, sibutramine, liraglutide, semagglutide, phentermine-topiramate and naltrexone- bupropion. A search for studies was carried out in the NCBI Pubmed / Medline Pubmed, Embase and Scopus databases, including randomized controlled clinical trials (RCT). Studies published between 2010 and August 2020 were selected, with a follow-up period greater than or equal to one year, participants ≥18 years and with a body mass index ≥25 kg/m². Fourteen randomized, double-blind, placebo-controlled clinical trials were included, totaling 15,447 participants. Data from studies of observed incidence of at least 5% weight reduction with treatments and placebo were grouped. The meta-analysis demonstrated a greater chance of losing at least 5% of weight in patients who used liraglutide compared to placebo, with an odds ratio of 2.60 (95% confidence interval, 1.26-5, 42; P <0.05). Regarding adverse effects, pharmacological interventions showed higher rates of gastrointestinal tract events compared to placebo. Finally, although liraglutide has shown statistically significant results for greater reduction in body mass, further studies are needed to define drug associations with weight loss.De acordo com a Organização Mundial da Saúde (OMS), no ano de 2016, mais de 1,9 bilhão de adultos, com 18 anos ou mais, estavam com sobrepeso, sendo 650 milhões destes com obesidade. Assim, estratégias eficientes de tratamento são necessárias para o controle dessas condições, sendo a terapia medicamentosa indicada em alguns casos. Na literatura, há uma carência de estudos que compare a eficácia de diferentes tipos de fármacos no tratamento da obesidade. Logo, esta revisão sistemática com meta-análise visou comparar a eficácia de diferentes tratamentos farmacológicos no sobrepeso e na obesidade sobre a redução da massa corporal e os efeitos adversos, sendo eles: orlistate, sibutramina, liraglutida, semaglutida, fentermina-topiramato e naltrexona-bupropiona. Foi realizada uma busca de estudos nas bases de dados do NCBI Pubmed/Medline Pubmed, Embase e Scopus, sendo incluídos ensaios clínicos randomizados e controlados (ECR). Foram selecionados estudos publicados entre 2010 e agosto de 2020, que tivessem período de seguimento maior ou igual a um ano, participantes ≥18 anos e com índice de massa corpórea ≥25 kg/m². Quatorze ensaios clínicos randomizados, duplos-cegos e controlados por placebo foram incluídos, totalizando um número de 15.447 participantes. Foram agrupados dados dos estudos de incidência observada de no mínimo 5% de redução de peso com os tratamentos e placebo. A meta-análise demonstrou chance maior na perda de pelo menos 5% de peso nos pacientes que fizeram uso de liraglutida em comparação com o placebo, com odds ratio de 2,60 (Intervalo de confiança de 95%, 1,26-5,42; P<0,05). Em relação aos efeitos adversos, as intervenções farmacológicas apresentaram taxas maiores de eventos do trato gastrointestinal em comparação com placebo. Por fim, embora a liraglutida tenha demonstrado resultados estatisticamente significativos para maior redução de massa corporal, mais estudos são necessários para definir a eficácia entre os diferentes fármacos na perda de peso

Evaluation of nursing process at a university hospital in Campina Grande

Objectives: to identify the application of the nursing process and analyze the records of each stage. Methods: This was a retrospective and descriptive study with a quantitative approach, based on the reports and records of the process presented in the records of ward B and that were in the SAME of a University Hospital in Campina Grande. After data collection, the data were analyzed by the descriptive method and the absolute and relative frequencies were calculated. Results: Of the 115 (100%) charts collected, the records presented all stages of the process, except for the expected results. The most frequent diagnoses were ineffective breathing pattern and intolerance to activity and interventions, to check vital signs and oxygen saturation. In 68 (59,1%) the actions implemented were recorded, 114 (99,1%) did not present the patient's answers and 71 (61.7%) made changes to the care plans. Conclusion: It was concluded that it is necessary to improve the registration of the nursing process

PODER DE POLÍCIA ADMINISTRATIVA NA FISCALIZAÇÃO DOS CONSELHOS REGIONAIS DE ENFERMAGEM.

O estudo tem por objetivo descrever o processo histórico de criação do Sistema Conselho Federal de Enfermagem/Conselhos Regionais de Enfermagem com ênfase no poder de polícia administrativa dos conselhos de fiscalização profissional. Estudo bibliográfico e documental abstraído de materiais bibliográficos (publicações periódicas: revistas e livros) e documentos (impressos diversos: leis, decretos, súmulas e resoluções de enfermagem), disponíveis em meio impresso e eletrônico, analisados por meio da técnica de analise de conteúdo. Os resultados descrevem que o poder de polícia administrativa tem seu poder fundamentado no princípio da predominância do interesse público sobre o particular (profissional ou empresa de enfermagem), deixando a administração pública em posição de supremacia sobre os interesses particulares

American tegumentary leishmaniasis: epidemiological and molecular characterization of prevalent Leishmania species in the State of Tocantins, Brazil, 2011-2015

Determination of the epidemiological profile of the American tegumentary leishmaniasis (ATL) and identification of Leishmania species that are prevalent in the State of Tocantins were carried out through a retrospective and descriptive study based on data reported in SINAN, in the period from 2011 to 2015. Molecular techniques such as PCR-RFLP and PCR-G6PD to amplify Leishmania DNA were performed on stored on Giemsa-stained slides from lesion scarifications of ATL patients who were amastigote-positive by the direct microscopic examination. There were 1,434 ATL cases in Tocantins reported in this period. The highest incidence was reported in men aged over 60 years, rural residents, the most affected ethnic group was mixed ethnicity (mixed black and white) and the ones with lower education. The predominant clinical form was cutaneous, being diagnosed mainly by laboratory methods. Pentavalent antimonial was effective in resolving cases. The predominant species found in 271 analyzed samples from 32 municipalities located in 8 different health regions of Tocantins was Leishmania (Viannia) braziliensis. Identifying the epidemiological profile and characterizing the Leishmania spp species on regional level is essential to establish control and prevention behaviors, minimizing the number of cases and treatment resistance, recurrence and evolution to mucosal forms

Estresse hídrico e salino na germinação de sementes de Anadenanthera colubrina (Veloso) brenan

The objective of this work was to verify levels of tolerance in Anadenanthera colubrina seeds to water and salt stress simulated for polyethyleneglycol 6000 (PEG 6000), manitol and KCl. The seeds was collected from nine trees and stored in cold chamber at 5 ºC. For the evaluation of the germination under it water stress was used PEG 6000 solutions and manitol, and under salt stress solutions of KCl in different osmotic potentials: 0.0 Mpa (control), -0.6 MPa, -0.8 MPa, -1.0 MPa, -1.2 MPa and -1.4 Mpa. The seeds were made use in gerbox and placed in germination chambers, under constant light to the temperature of 25 ºC. The percentage and the germination speed index (GSI) were evaluated. The seeds of Anadenanthera colubrina showed moderate tolerance to the water stress simulated by PEG 6000. The percentage of germination was affected from -1.0 MPa, and the GSI from -0.6 Mpa. Manitol did not reveal efficient in the simulation of water stress, therefore it did not reduce the percentage of germination. Under it salt stress, simulated for KCl, the germination percentage was affected from the potential -1.2 MPa, characterizing a high limit of tolerance to this salt.O objetivo deste trabalho foi avaliar os níveis de tolerância das sementes de angico-branco ao estresse hídrico e salino simulados por polietilenoglicol 6000 (PEG 6000), manitol e KCl. As sementes foram coletadas de nove matrizes no município de Colombo - PR e armazenadas em câmara fria a 5 ºC. Para a avaliação da germinação sob estresse hídrico foram utilizadas soluções de PEG 6000 e manitol, e sob estresse salino, soluções de KCl nos seguintes potenciais osmóticos: 0,0 Mpa (testemunha), -0,6 MPa, -0,8 MPa, -1,0 MPa, -1,2 MPa e -1,4 Mpa. As sementes foram dispostas em gerbox e acondicionadas em câmaras de germinação, sob luz constante à temperatura de 25 ºC. Foram avaliados a porcentagem e o índice de velocidade de germinação. As sementes de angico- branco apresentaram moderada tolerância ao estresse hídrico simulado por PEG 6000. A porcentagem de germinação foi afetada drasticamente a partir de -1,0 MPa e, a velocidade de germinação a partir de -0,6 Mpa. O manitol não foi eficiente na simulação de estresse hídrico, pois não reduziu a porcentagem de germinação em nenhum dos potenciais testados. Sob estresse salino, simulado por KCl, a porcentagem de germinação foi afetada a partir do potencial -1,2 MPa, caracterizando limite elevado de tolerância a este sal

Knowledge, attitude and practice of condom use by women of an impoverished urban area

OBJECTIVE Assessing the adequacy of knowledge, attitude and practice of women regarding male and female condoms as STI/HIV preventive measures. METHOD An evaluative Knowledge, Attitude and Practice (KAP) household survey with a quantitative approach, involving 300 women. Data collection took place between June and August 2013, in an informal urban settlement within the municipality of João Pessoa, Paraiba, Northeast Brazil. RESULTS Regarding the male condom, most women showed inadequate knowledge and practice, and an adequate attitude. Regarding the female condom, knowledge, attitude and practice variables were unsatisfactory. Significant associations between knowledge/religious orientation and attitude/education regarding the male condom were observed. CONCLUSION A multidisciplinary team should be committed to the development of educational practices as care promotion tools in order to improve adherence of condom use

ATLANTIC-CAMTRAPS: a dataset of medium and large terrestrial mammal communities in the Atlantic Forest of South America

Our understanding of mammal ecology has always been hindered by the difficulties of observing species in closed tropical forests. Camera trapping has become a major advance for monitoring terrestrial mammals in biodiversity rich ecosystems. Here we compiled one of the largest datasets of inventories of terrestrial mammal communities for the Neotropical region based on camera trapping studies. The dataset comprises 170 surveys of medium to large terrestrial mammals using camera traps conducted in 144 areas by 74 studies, covering six vegetation types of tropical and subtropical Atlantic Forest of South America (Brazil and Argentina), and present data on species composition and richness. The complete dataset comprises 53,438 independent records of 83 species of mammals, includes 10 species of marsupials, 15 rodents, 20 carnivores, eight ungulates and six armadillos. Species richness averaged 13 species (±6.07 SD) per site. Only six species occurred in more than 50% of the sites: the domestic dog Canis familiaris, crab-eating fox Cerdocyon thous, tayra Eira barbara, south American coati Nasua nasua, crab-eating raccoon Procyon cancrivorus and the nine-banded armadillo Dasypus novemcinctus. The information contained in this dataset can be used to understand macroecological patterns of biodiversity, community, and population structure, but also to evaluate the ecological consequences of fragmentation, defaunation, and trophic interactions. © 2017 by the Ecological Society of Americ